Updated: May 19
16th May 2021
UK COVID Deaths – Daily 4 / 7-Day average 10
Total UK COVID Deaths within 28 days – 127,679
Total UK Deaths with COVID-19 on the death certificate – 151,765 (up to 30 Apr)
James Cook Hospital – Total COVID deaths – 612
All COVID cases within South Tees Hospitals Trust – 11
James Cook Critical Care
COVID cases – 2 (2 ventilated)
Non-COVID cases – 53 (31 ventilated)
Tomorrow marks the next step in the Government’s ‘Roadmap to Freedom’. It’s a big step - the biggest one yet. From tomorrow we can socialise indoors with other households, drink and eat inside in pubs and restaurants. We can go to the cinema or the theatre and some are even jetting off abroad on holiday. Students are returning to lectures and my children are delighted that they no longer have to wear facemasks in class.
Reassuringly, cases in the community are continuing to fall. The Office for National Statistics (ONS) infection survey suggests that just 1 in 1350 people in the UK are currently testing positive for COVID-19. Whilst social-distancing rules will remain in place tomorrow, there is no doubt that we will see increasing virus transmission. What we shouldn’t see, as a result of the nation’s vaccination programme, is the large rise in hospital admissions that ultimately followed a similar relaxation of restrictions at the end of the first wave.
From next week, vaccination will be offered to those aged over 35 years of age. So far, nearly 70% of the country’s adult population have received the first dose of a vaccine and nearly 40% have been vaccinated twice. Even better is that vaccine uptake has been high in the most at risk groups; 95% of the over 50’s have accepted the offer of vaccination. Further information has been published showing just how effective vaccination is at affording protection from COVID-19. Israel has reported that two doses of the Pfizer vaccine offer more than 97% protection against symptomatic COVID-19 infection, hospitalisation and death. The vaccine was effective across all age groups and against the predominant UK ‘Kent’ variant.
Of course, it’s the new Indian variant that currently has everyone’s attention. It’s feared that this variant may be up to 50% more transmissible than the UK variant, which would make it horribly infectious. This is a worry, given the indoor mixing of the population that is going to begin tomorrow. If this is true then the Indian variant will become the dominant strain in the UK and ultimately, the world.
However, there is some confidence that current vaccines should still offer significant protection against this variant. Early laboratory data on vaccine efficacy is reassuring, which has not been the case with the other variants. The worry over the South African variant followthe d initial laboratory studies that suggested that vaccines produced a reduced neutralizing-antibody response in response to the South African strain of the virus. However, real-world data has proved more encouraging and a recent study from Qatar suggests that two doses of the Pfizer vaccine confers significant protection against infection with the South African variant, with a quoted efficacy of 75%.
There is currently no suggestion that the Indian variant is more likely to cause severe disease. The Health Secretary today announced that there have been a handful of vaccinated people who have been admitted to hospital in Bolton following infection with the Indian variant. All bar one, had only received one dose of a vaccine and so this does not technically constitute vaccine failure. The one individual who had received a second dose was described as ‘frail’ which appears, not surprisingly, to be a risk factor for vaccine failure.
My hospital is still admitting the occasional COVID patient and last weekend we admitted our first COVID patient to the ICU in many weeks. The patient was in their late 30’s and hadn’t been vaccinated. Fortunately they improved quickly with CPAP and were only with us for a few days before returning to the ward.
We now have only two recovering COVID patients within Critical Care. I’m pleased to report that another one of our long-stay COVID patients has been successfully discharged to the ward. This particular patient was admitted back in January after developing severe COVID pneumonitis. He has spent a total of 105 days on the Intensive Care Unit and there were many, many occasions when it looked like he was not going to survive. We count his survival as one of our major successes during the pandemic.
There is more good news closer to home. Nicky’s father, Gordon, has been undergoing chemotherapy for a new diagnosis of Non-Hodgkin’s Lymphoma. He started his first round of chemotherapy toward the end of December and then became very unwell with COVID pneumonitis just before Christmas. Fortunately he made a good recovery but had to restart his chemotherapy again once he had recovered. We had been worried about how poorly he had been after his first chemotherapy treatment but, as it turned out, a lot of what he thought were chemotherapy side-effects were actually COVID symptoms. He has tolerated his subsequent chemotherapy treatments quite well and I’m pleased to announce that, after a repeat scan, he has been told that he has had a good response and doesn’t need any more. He will still need to take immunosuppressive treatment and the haematology team at Hull will be keeping a close eye on him, but there is no denying that this is great news and a huge relief to us all.
Both my parents and Nicky’s have now been vaccinated twice and, with Gordon’s immune system now recovering after the chemotherapy, there is now the opportunity for the children to safely hug their grandparents and for some aspects of life to belatedly return to normal.
Of course everyone is free to hug whomever they choose from tomorrow. However, the Government has started to suggest that a little more caution may be needed, given the proliferation of the Indian variant. The next few weeks will be the first true test of how well our vaccines work in a more open, less socially-distant society. I remain relatively optimistic but it’s clear that we remain in a race between the virus and the pace of vaccination. Unfortunately, the Indian variant may have slipped COVID a faster pair of running shoes. It will become clear over the next month whether or not we can keep pace.